Absolute risk of acute coronary syndrome after severe hypoglycemia: A population‐based 2‐year cohort study using the National Database in Japan. Issue 2 (7th November 2019)

• Record Type: Journal Article
• Authors: Nishioka, Yuichi; Okada, Sadanori; Noda, Tatsuya; Myojin, Tomoya; Kubo, Shinichiro; Ohtera, Shosuke; Kato, Genta; Kuroda, Tomohiro; Ishii, Hitoshi; Imamura, Tomoaki
• Is Part Of: Journal of diabetes investigation. Volume 11:Issue 2(2020)
• Page Start: 426
• Page End: 434
• Publication Date: 2019-11-07
• Subjects: Acute coronary syndrome -- Diabetes -- Hypoglycemia; Diabetes -- Periodicals; Diabetes -- Research -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462005
• DOI: 10.1111/jdi.13153
• Languages: English
• ISSNs: 2040-1116

Abstract

Abstract: Aims/Introduction: Although the epidemiological relationship between hypoglycemia and increased risk of acute coronary syndrome (ACS) has been well established, the time period for increased risk of ACS after a severe hypoglycemic episode remains unknown. The present study aimed to determine the ACS risk after a severe hypoglycemic episode. Materials and Methods: We carried out a retrospective population‐based cohort study based on national claims data in Japan. We retrieved data of diabetes patients aged ≥35 years collected from April 2014 to March 2016. The absolute risk of ACS was defined as the occurrence of an emergency percutaneous coronary intervention after a severe hypoglycemic episode. Results: In total, data of 7, 909, 626 patients were included in the analysis. The absolute risk of ACS was 2.9 out of 1, 000 person‐years in all patients. ACS risk in patients with severe hypoglycemic episodes was 3.0 out of 1, 000 person‐years. Severe hypoglycemic episodes increased the absolute risk of ACS in patients aged ≥70 years, but not in patients aged <70 years. The absolute risk of ACS was 10.6 out of 1, 000 person‐years within 10 days of a severe hypoglycemic episode. There was a significant trend between shorter duration after an episode and higher ACS risk. Conclusions: Severe hypoglycemia was associated with an increased risk of ACS in elderly diabetes patients. ACS risk increased with a shorter period after a severe hypoglycemic episode, suggesting that severe hypoglycemia leads to an increased risk of ACS in diabetes patients. These findings show that it is important to avoid severe hypoglycemia while treating diabetes, particularly in elderly patients. Abstract : This study identifies the absolute risk of acute coronary syndrome in Japanese patients after they have experienced a severe hypoglycemic episode. Study results showed that acute coronary syndrome risk increased considerably within a short period after a severe hypoglycemic episode, indicating a strong association between the length of time after a severe hypoglycemic episode and acute coronary syndrome risk.